title: Matrix removal of labyrinthine fistulae by non-suction technique with intraoperative dexamethasone injection.
abstract: CONCLUSIONS
  Matrix removal by a non-suction technique with intraoperative dexamethasone injection is a safe and effective management modality, regardless of fistula size.
  
  
  OBJECTIVE
  Our goal was to evaluate the outcome of hearing treated by non-suction technique with intraoperative dexamethasone injection.
  
  
  METHODS
  This was a retrospective chart review of 720 mastoidectomy cases for cholesteatoma, performed at our tertiary otolaryngologic care centers between 2005 and 2012. A total of 17 patients with a unilateral labyrinthine fistula were encountered.
  
  
  RESULTS
  There was no recurrent cholesteatoma in any of the patients. In all cases, the matrix was removed by intraoperative dexamethasone injection with a bimanual non-suction technique, regardless of the fistula size. None of the patients showed deteriorated bone conduction (BC). Averaged BC was unchanged (n = 13) or improved (n = 4) in all patients and did not decrease by 10 dB more in any patient. The mean threshold of postoperative BC was significantly improved compared with preoperative mean threshold. Fistulae on the preoperative CT scans ranged from 1.41 to 7.12 mm and averaged 2.89 mm. There was no correlation between the fistula size and the postoperative BC level. Even with a large fistula, postoperative hearing preservation was possible with one-stage matrix removal.
authors.affiliation: Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea. chulsavio@hanmail.net
authors.forename: Chul Ho
authors.initials: CH
authors.lastname: Jang
authors.forename: Si Young
authors.initials: SY
authors.lastname: Jo
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D018424:Cholesteatoma, Middle Ear / Q000150:complications; D000075202:Contraindications; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006319:Hearing Loss, Sensorineural / Q000517:prevention & control*; D006801:Humans; D007430:Intraoperative Care; D007759:Labyrinth Diseases / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013396:Suction; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone